The principle of the double effect has come to have a very respected and influential position in medical ethics. This doctrine is often employed to explain the morality and validity of an action that may have harmful consequences—such as the death of a human as a “side effect” of advancing another good end. The principle goes that in certain situations, it is permissible to cause serious harm as long as, the good effect of the act is proportionately good enough, and the agent, while foreseeing the bad effect, only intends the good effect and not the bad one (Thomson, 1999). In Judith Jarvis Thomson’s article Physician-Assisted Suicide: Two Moral Arguments, Thomson further explores this principle with respect to the relevance of the difference …show more content…
This principle is heavily rooted in Catholic moral tradition, and Thomas Aquinas outlines the four conditions one must consider when an act has both good and bad effects: 1) The act must be inherently good, or at least morally neutral; 2) The bad effect may be anticipated, but not intended; 3) The good effect must not be achieved by means of the bad effect; and 4) There must be a proportionately grave reason for allowing the bad effect (Summa Theologica (II-II, Qu. 64, Art.7)). The example above about the woman with MS is an example of a situation with a double effect. Perhaps one of the most commonly cited examples is that of pain management at the end of life and the inadvertent suppression of respiration with the use of high doses of potentially lethal medication. Many health care professionals rely on the principle of the double effect to explain why these actions are permissible (Latimer, 1991). In Thomson’s report, she refers to this example and asserts that determining the legal permissibility of administering such a lethal dose should depend only on the patient’s condition and wishes. She goes on to say that weighing the permissibility of the action on whether the doctor would do so intending death or only intending relief from pain is an “absurdity” (Thomson,
Another instance of how someone’s right to bodily autonomy can surpass the right to life can be understood when thinking about end of life scenarios. Marquis’s argument suggests it would be immoral for a doctor to take a comatose patient off life support, even if the patient previously arranged to be taken off life support. Following Marquis’s logic because a person in a vegetative state could theoretically wake up in the future, a doctor would be obligated to keep them on life support against their wishes. Additionally, as Marquis briefly mentions in his paper, people suffering from terminal illness must also be denied euthanasia (197). In find it troubling that Marquis seems to have arbitrarily decided that even adult human beings do not have the right to make medical decisions that would greatly lessen their suffering. Additionally, Marquis’s argument also suggests that committing suicide would not only be immoral,
There are many convincing and compelling arguments for and against Physician Assisted Suicide. There are numerous different aspects of this issue, including religious, legal and ethical issues. However, for the purpose of this paper, I will examine the ethical concerns of both sides. There are strong pro and con arguments regarding this, and I will make a case for both. It is definitely an issue that has been debated for years and will continue to be debated in years to come.
There are many legal and ethical issues when discussing the topic of physician-assisted suicide (PAS). The legal issues are those regarding numerous court cases over the past few decades, the debate over how the 14th Amendment of the United States Constitution comes into play, and the legalization vs. illegalization of this practice. The 14th Amendment states, “nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws” (U.S. Const. amend. XIV, §1). PAS in the past has been upheld as illegal due to the Equal Protection Clause of the 14th amendment of the constitution, but in recent years this same 14th amendment is also part of the reasoning for legalizing PAS, “nor shall any State deprive any person of…liberty” (U.S. Const. amend. XIV, §1). The ethical issues surrounding this topic include a patient’s autonomy and dignity and if PAS should be legalized everywhere. This paper is an analysis of the PAS debate and explores these different issues using a specific case that went to the supreme courts called Washington et al. v. Glucksberg et al.
Imagine, if you will, that you have just found out you have a terminal medical condition. Doesn’t matter which one, it’s terminal. Over the 6 months you have to live you experience unmeasurable amounts of pain, and when your free of your pain the medication you’re under renders you in an impaired sense of consciousness. Towards the 4th month, you begin to believe all this suffering is pointless, you are to die anyways, why not with a little dignity. You begin to consider Physician-Assisted Suicide (PAS). In this essay I will explain the ethical decisions and dilemmas one may face when deciding to accept the idea of Physician-Assisted Suicide. I will also provide factual information pertaining to the subject of PAS and testimony from some that advocate for legalization of PAS. PAS is not to be taken lightly. It is the decision to end one’s life with the aid of a medical physician. Merriam-Webster’s Dictionary states that PAS is “Suicide by a patient facilitated by means (as a drug prescription) or by information (as an indication of a lethal dosage) provided by a physician aware of the patient’s intent.” PAS is considered, by our textbook – Doing Ethics by Lewis Vaughn, an active voluntary form of euthanasia. There are other forms of euthanasia such as non-voluntary, involuntary, and passive. This essay is focusing on PAS, an active voluntary form of euthanasia. PAS is commonly known as “Dying/Death with Dignity.” The most recent publicized case of PAS is the case of Brittany Maynard. She was diagnosed with terminal brain cancer in California, where she lived. At the time California didn’t have Legislative right to allow Brittany the right to commit PAS so she was transported to Oregon where PAS is legal....
In the medical field, there has always been the question raised, “What is ethical?” There is a growing conflict between two important principles: autonomy and death being considered a medical treatment. Physician assisted suicide is defined as help from a medical professional,
The idea of Physician-Assisted suicide is one that carries many misconceptions and comes with much opposition. Of these opponents, many are doctors and nurses. This opposition is deeply rooted in the belief that the practice of medicine is one that has the sole purpose to increase the quality of life for people and to prolong life. These beliefs are rooted in the Hippocratic Oath, an Oath that all doctors promise to uphold. The Hippocratic Oath proclaims that “I will give no deadly medicine to anyone if asked, nor suggest any such counsel” ("The End of Life: Ethical Considerations"). This Oath is a major reason for many nurses and doctors opposing the practice; however, it is not the only source for opposition. In addition to the Hippocratic...
...d how these determinations effect a physician’s approach to various types of critically ill patients? These types of questions come in to play when one attempts to critically analyze the differences between the types of terminally ill patients and the subtle ethical/legal nuances between withholding and withdrawing treatment. According to a review by Larry Gostin and Robert Weir about Nancy Cruzan, “…courts examine the physician’s respect for the desires of the patient and the level of care administered. A rule forbidding physicians from discontinuing a treatment that could have been withheld initially will discourage doctors from attempting certain types of care and force them prematurely to allow a patient to die. Physicians must be free to exercise their best professional judgment, especially when facing the sensitive question of whether to administer treatment.”
Oncol, Ann. "Bad News for Taxpayers, Good News for Patients, in the UK." Annals of Oncology 13.6 (2002): 811-13. Oxford Index. Web. 16 Jan. 2014. This work is useful because it is a medical citation that gives the paper higher credibility and background. It helps provide a medical analysis on mercy killing and assisted suicide, the stance taken on the novel.
Three people can have the same condition, but only one will find the suffering unbearable. People suffer, but suffering is as much a function of the values of individuals as it is of the physical causes of that suffering. Inevitably in that circumstance, the doctor will in effect be treating the patient's values. To be responsible, the doctor would have to share those values. The doctor would have to decide, on her own, whether the patient's life was "no longer worth living."
“Michael Manning, MD, in his 1998 book Euthanasia and Physician-Assisted Suicide: Killing or Caring?, traced the history of the word euthanasia: ‘The term euthanasia.originally meant only 'good death,'but in modern society it has come to mean a death free of any anxiety and pain, often brought about through the use of medication.” It seems there has always been some confusion and questions from our society about the legal and moral questions regarding the new science of euthanasia. “Most recently, it has come to mean'mercy killing' — deliberately putting an end to someone’s life in order to spare the individual’s suffering.’” I would like to emphasize the words “to spare the individual’s suffering”.
It’s hard to recognize the outcome and have an objective view about certain issue without knowing what is its’ actual definition. The definition of physician-assisted suicide is “when a person - typically someone suffering from an incurable illness or chronic intense pain - intentionally kills him/herself with the help of a doctor. A doctor may prescribe drugs on the understanding that the patient intends to use them to take a fatal overdose; or a doctor may insert an intravenous needle into the arm of a patient, who then pushes a switch to trigger a fatal injection”( ETHICAL DEBATE: On the horns of a dilemma.）.
Cotton, Paul. "Medicine's Position Is Both Pivotal And Precarious In Assisted Suicide Debate." The Journal of the American Association 1 Feb. 1995: 363-64.
It allows for a highly questionable distinction between killing and letting die, which, if accepted, lead to indefensible medical decisions. Sullivan chooses to focus on the integrity of the Doctrine. The AMA Doctrine delivers the distinction between ordinary and extraordinary care. Ordinary care is obtained without excessive expense, pain or other inconvenience, while, extraordinary care is all treatment that does not fall under ordinary care and attempts to prolong the life of a terminally ill patient. The Doctrine can be considered a simple prohibition of murder, ensuring that doctors do not without ordinary care, because doing so would be considered killing. Rachels example seen convincing because they deal with withholding ordinary care but he fails to distinguish ordinary from extraordinary, then attacks the lack of ordinary care. This can be found in the Downs Syndrome Baby example, where severe down’s syndrome babies born with intestinal obstructions. Sometimes in such cases the baby is permitted to die. Rachels argues that in such cases we find compelling moral grounds for preferring active euthanasia to passive euthanasia in the vastly greater degree of suffering involved in letting the baby die. The AMA policy, strictly interpreted, seems to allow newborn Down Syndrome babies to die from intestinal blockages, though this is not the reason that parents think it best to let the babies die. Sullivan would deem that if the baby is suffering and their quality of life would not be adequate then the baby should be permitted to die. In the case of the Downs Syndrome Baby it would be permissible to withhold extraordinary care, according to Sullivan. The doctor, in removing extraordinary care, does not intend to kill the patient, but to spare the baby any suffering that may be endured through extraordinary
A divergent set of issues and opinions involving medical care for the very seriously ill patient have dogged the bioethics community for decades. While sophisticated medical technology has allowed people to live longer, it has also caused protracted death, most often to the severe detriment of individuals and their families. Ira Byock, director of palliative medicine at Dartmouth-Hitchcock Medical Center, believes too many Americans are “dying badly.” In discussing this issue, he stated, “Families cannot imagine there could be anything worse than their loved one dying, but in fact, there are things worse.” “It’s having someone you love…suffering, dying connected to machines” (CBS News, 2014). In the not distant past, the knowledge, skills, and technology were simply not available to cure, much less prolong the deaths of gravely ill people. In addition to the ethical and moral dilemmas this presents, the costs of intensive treatment often do not realize appreciable benefits. However, cost alone should not determine when care becomes “futile” as this veers medicine into an even more dangerous ethical quagmire. While preserving life with the best possible care is always good medicine, the suffering and protracted deaths caused from the continued use of futile measures benefits no one. For this reason, the determination of futility should be a joint decision between the physician, the patient, and his or her surrogate.
Further, Brooke LJ was also of the opinion that the doctrine of double effect could not apply in this case. The reason being it was impossible to say that the surgeons would be acting in Mary’s best interest when the operation would save Jodie but kill her. Robert Walker LJ was also stated eventhough the operation would be in the best interest of both twins, he acknowledged that to kill Mary merely because it was in her best interest to die would be murder. He was also of the opinion that, in law, it could hardly be regarded as anything other than an evil consequence. However, the evil consequence would not be unlawful because it was not the motive or intention of the operation.